Carsinoma Doctor

At the time of filing, over 50% of patients with esophageal cancer have metastatic disease. The use of chemotherapy for this group of patients is increasing, with the intention of gaining control of local and distant tumor, improvement of quality of life and prolonging survival.
Evaluate the effectiveness of a) chemotherapy versus best supportive care or b) different chemotherapy regimens with each other in metastatic carcinoma of the esophagus.
Only two RCTs with 42 participants compared chemotherapy with best supportive care for metastatic cancer of the esophagus. In these RCTs, showed no survival benefit for chemotherapy. Five RCTs with 1 242 participants compared different chemotherapy regimens. Because of the variation in the population of patients and chemotherapy regimens, it was not possible to make a formal pooled analysis. There was no consistent benefit of any specific chemotherapy regimen.
Authors’ conclusions

Trials are needed well-designed phase III, and adequately powered, comparing chemotherapy versus best supportive care in patients with metastatic cancer of the esophagus. Chemotherapy agents with encouraging response rates and tolerable toxicity are cisplatin, 5-fluorouracil (5-FU), paclitaxel and anthracyclines. Future trials comparing palliative treatment modalities should assess the quality of life with quality of life measures validated.

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